Provider Demographics
NPI:1659401677
Name:KING PHILIP REG SCHOOL DISTRICT
Entity Type:Organization
Organization Name:KING PHILIP REG SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAEFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-520-7991
Mailing Address - Street 1:201 FRANKLIN ST
Mailing Address - Street 2:BOX 49
Mailing Address - City:WRENTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02093-2404
Mailing Address - Country:US
Mailing Address - Phone:508-384-1000
Mailing Address - Fax:
Practice Address - Street 1:201 FRANKLIN ST
Practice Address - Street 2:BOX 49
Practice Address - City:WRENTHAM
Practice Address - State:MA
Practice Address - Zip Code:02093-2404
Practice Address - Country:US
Practice Address - Phone:508-384-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1952226Medicaid